Marja and Claudio
looked at each other fondly and held hands under the table. But they didn't meet my eyes. I narrowed mine,
and leaned forward.

"May I ask a
question?"

"Absolutely!" Claudio waved expansively, and poured
himself another glass of wine.

"DID you have
a
night of wild nuptial bliss?" I said. "I don't know of a single couple
who, in real life,
on their actual wedding night, actually did.
A wedding is mostly this huge, stressy, organized-to-the-walls THING, and even
if it isn't stressy or messy, the party afterwards is generally pretty
epic, and
by the time you've escaped from the guests and gotten back to your room,
any
reasonable person just wants to go to SLEEP.
I reckon that there isn't actually a
single wedded couple - at least, any a couple that isn't required to
produce proof of consummation in the morning, or isn't 18 and invincibly
horny - who DOES consummate
their marriage on their wedding night!" I sat back and took
a deep breath. "There." I said.
"A speech."

Marja and Claudio
looked at each other. They looked at me.

"To answer your
question," Claudio said slowly, "We did NOT.
To be honest, I didn't even carry her very far over the threshold."

"About three
steps." Marja giggled.
"Then he fell over. It was two o'clock in the morning when we got upstairs, and it had been a LONG day!"

"First I picked
her up at her parents house - at noon -"

"And then we
went to the courthouse -"

"And then the
church -"

"And then we
had a party -"

"A REALLY good party- "

"And after
THAT, lifting her up to carry her across the threshold almost floored me. We
sort of OOOZED across, with her feet about an inch above the floor -"

"And then we
went to sleep." Marja grinned. "But the day afterward - THAT was
another story."

Mr Tabubil
and I
were married at ten o'clock in the morning, barefoot, on a beach. We were married
out of a small hotel in Titikaveka on the Island of Rarotonga, and
after the ceremony, we and our few beloved guests repaired to the
hotel's little restaurant for a truly EPIC wedding breakfast. The
weather was tropical hot and tropical sticky, and when the party
floated
to a finish, Mr Tabubil and I, drowning in our splendid wedding togs, dribbled upstairs to our room, throwing
promises behind us to see everyone again on the beach, in an hour -
just enough time for a shower and a change of clothes and the briefest of
restorative shut-eyes- that's all -

In our room we
barely had the strength to close the door and slip off the dress and the suit
before we fell face-down on the bed and fell asleep, his hand on mine, clasped together
over our fine new rings.

We woke up three hours later to the sound of laughter
and splashing below our window. We
slipped into swimsuits and went down to join our guests and only came out of the
water when the sky had turned red and the sun was setting over the reef.

Upstairs again, we
discovered that while we were down in the water, the housekeeper of the hotel
had crept up into our room and laid out a wedding tableaux. Two cane chairs had been dragged over to the
window and turned so that they faced the
sea. A small table had been placed laid
between them, and laid with my wedding flowers, a candle and a box of matches and
a bottle of champagne. Over the back of
the chair she had draped a brand new pareo, in the same shades of blue and
purple as the water outside. The bed had
been turned down for sleep, and as a final touch, the housekeeper had gone into
the closet and found a lacy little bit of nothing that I had brought with me in
my suitcase, and she had smoothed it flat and laid it out across my pillow.

It was perfect.

But this wasn't an
evening for romance. We were new-married
in paradise, but we were also in the middle of a one-week window where we had
the north American friends that we loved best in the same place as ourselves, so we dried ourselves off and
walked across the road to a little cottage where our Canadian friends were staying, and a rather splendid after-party
burst into the black tropical night like a catherine wheel.

We crept home again
at three in the morning, and slipped into bed and fell straight asleep.

When we woke the sun
was high in the sky, and looking around the room at the untouched wedding
tableaux, we felt a terrible remorse. The housekeeper had spent such time and shown
such kindness setting up the perfect nuptial night, and there we were, the
unspoken wedding cliché, and all her efforts wasted.

So we stepped into
the breach.

Mr Tabubil dragged
the chairs around to face each other and lit the candle to blacken the wick and blew it out again, and dropped the spent match on the table. I wadded the freshly pressed pareo into a
ball to crease it, and pulled it straight again, and dragged it across the
floor half-way to the bed and left it there.
While Mr Tabubil twisted our bedsheets and pillows into a perfect storm of
acrobatic disarray, I took the lacy bit of nothing and wadded it up and
shoved it underneath one of the pillows - and considered it, and took it by the
corner and dragged it out again and left it hanging artistically half-way down
to the floor.

We looked at the
chaos and smiled. We'd said
thank you. In the best possible way -
with a tableaux to match her own.

And Mr Tabubil took
my hand and we went down to breakfast.

Happy anniversary,
Mr Tabubil. It's been three wonderful years. Here's to another three, to match Marja and
Claudio's six, and three more after that and three score times three -

Friday, September 28, 2012

My
sister, the estimable Dr Tabubil, is spending ten weeks on a rural
clinical rotation in Cloncurry, a small pastoral town in the Queensland
Outback. It's a fantastic place, and together we have collaborated on a
series of guest posts all about living and working in the Red Centre.
Enjoy!

My time in Cloncurry
ended with a bit of a bang. On my second last
day, I walked the quarter-kilometer home to my loaner house for
lunch, and somewhere in the near distance, there was an enormous cloud of black smokeclimbing up into the sky. It was as
near as the other side of town, but I could not smell any smoke in the
air.

A fire clearly, but the
wind was blowing in a northerly direction, and I was eastward of the fire -

I didn’t have the
courage to grab my car and drive over to see what was going on.Bush-fires in Australia are Dangerous.
It’s the triple threat combination of dry air, strong wind, and tall
grass. When the big bush-fires hit, lives can be- and often are -
lost.The worst, and most recent fires
have been the Black Saturday fires that took over whole swathes of Victoria in
the dry February of 2009.Those fires
took out whole towns, and 174 people died.

This one must have
been as big as the smoke column promised -within a half hourI could hear the fire-trucks screaming toward
the fire.But it couldn't be anything
too bad - so I finished my lunch(oh, I
will miss those two-hour lunch breaks when I’m back in Brisbane, andas likely as not, not taking a single break
all day, and lunching on a power bar, if I remembered to stash one in a
pocket….)and wandered back to the
clinic - where the sharing of information started.

There was a huge bushfire right on the edge of town, more or less directly across the highway
from the Hospital. The highway was closed, and traffic was not permitted
to leave or enter the town. You can imagine what this would have been
like for the road trains and the Gray Nomads, all on a tight schedule - but you
can imagine that it was much worse for us here in town!

There was a flurry
of activity from the Med Super and the GP registrar on call at the Hospital…
The Hospital was being evacuated! And this was news - A major Bushfire threatening a Major Rural Centre -
it went out on the television and the radio, and we were headline news all
across Australia.Which might be great
for Australia, but was not at all cheering for us.

Fortunately, there
were not too many inpatients in the hospital to be evacuated, but there are
quite a few residents in the nursing home section of the hospital.And what a day they had! It was the
most excitement they had had in years! Ambulances shuttled everyone
across to the newly completed Shire Council Hall, and we settled them all in
for the duration.

Over the afternoon,
the fire crews battled the flames, and eventually, they started to win.

The highway was
re-opened before dark.And no-one was
injured.

It was the hoped-for outcome, but it brought home the reality of how quickly things can go
wrong out here-big fires can eat
towns, and all you can do is hang on, and hope that you will ride it out! Before the end of
the day, the fire was under control and the patients were back in the Hospital
(shuttled back again in ambulances). They had spent about 3 hours total
in our makeshift wards and jury-rigged ER, and they talked about it for days - and
will probably continue to do so for months!

Wednesday, September 26, 2012

My sister, the estimable Dr Tabubil, is spending ten weeks on a rural clinical rotation in Cloncurry, a small pastoral town in the Queensland Outback. It's a fantastic place, and together we have collaborated on a series of guest posts all about living and working in the Red Centre. Enjoy!

Last weekend was the Quamby Rodeo. Quamby is 45 kilometers north of Cloncurry. Population 6. Unless it’s rodeo day. Then, the population jumps to more than 2,000! The Quamby Rodeo kicks off the rodeo season – the next weekend it’s the Cloncurry Merry Muster, and the weekend after it’s the Mt Isa Rodeo, but Quamby is regarded as the best – it’s only one day, but the crowds can get a lot closer to the action.

I drove out with four other people, and we arrived just in time for the Greasy Pig event. I've never seen this before. It was awful: 100 young men and women running after a poor, terrified wild pig. Eventually it was caught, and dragged back to the start line by its hind legs. Not the best start to a rodeo, actually. Apparently, Quamby is not on the "official" rodeo circuit, so does not need to abide by the regulations pertaining to animal cruelty...

Yeah. I got that.

I’ve never seen so many hot cowboys in my life - devastating young men, every way I looked. Tight jeans, button down shirts, and the ever-present Akubra hat. The faint smell of sweat as they brush past you, the side-long glance as they see a woman for the first time in weeks, and the crunch of gravel under their boots as they move to lock eyes with the bulls and the broncos. The motes of red dust that cling to your skin and your eyelashes, and make films over trees and animals lends a surreal quality to the day. Little children shriek with laughter as they gather handfuls of the red earth and fling it in the air.

I wore my own new Akubra hat and blended right in! Not really – I’m clearly a city girl. I got upset when my hat blew off and got dirt on it.

The mutton buster was delightful. This event is for the babies - tiny bronco-riders-in-training, their hats cut to fit the brim of their safety helmets, their eyes as terrified as the eyes of the sheep, as their fathers hold them on the animals back, all the one way from one side of the arena to the next (it's only 4 meters wide!). And the crowd roars in encouragement! Mutton busters mutton busting:

I kept myself busy photographing as much as possible. I was camped by the fence snapping photos of the men as they were flung off the broncos when there was a quiet, "Excuse me, please," from behind me. I turned to find an impossibly gorgeous horse breathing over my shoulder, red dun in color, and an intricate lead over its shoulder as the cowboy side-stepped it to the gait. It's impossible not to romanticize the life on a station when everything is in technicolor and softened by gatherings of people who haven't met for months.A young jackaroo waits for his turn in the ring.

Rodeo fans waiting on the fence.

But what I loved about it was that I finally understand what my patients mean when they say they muster. There was bull riding, bronco riding, and cow roping. And I get it now. When they tell me that the old leg wound is hurting from rubbing on the stirrup, I know why. I know why they get rolled by cattle and thrown by horses. I know why they are covered in dust when they walk into my rooms. Jackaroos tangle with bull-calfs.

Monday, September 24, 2012

My sister, the estimable Dr Tabubil, is spending ten weeks on a rural clinical rotation in Cloncurry, a small pastoral town in the Queensland Outback. It's a fantastic place, and together we have collaborated on a series of guest posts all about living and working in the Red Centre. Enjoy!

Hey Tabubilgirl -

Quamby rodeo was brilliant. I've never seen so many good looking cowboys in my life. I'm back now and blowing red dust out of my nose.Here are a few photos - amazing, eh?A jillaroo chases down a bull-calf.

Friday, September 21, 2012

My sister, the
estimable Dr Tabubil, is spending ten weeks on a rural clinical rotation in
Cloncurry, a small pastoral town in the Queensland Outback. It's a fantastic place, and together we have
collaborated on a series of guest posts all about living and working in the Red Centre. This post is written by me - Tabubilgirl. Enjoy!

Dear Dr Tabubil

I just learned
something fantastic. Did you know that the Royal Flying Doctor
Service started out right where you are in Cloncurry?

I am so going
full-out fan-girl on you right now, for being there. You lucky doctor, you!

-A highly excited
Tabubilgirl.

I find it very hard
to write sensibly about the flying doctor, so - in advance - I ask you to
please excuse all of the hyperbole that has crept into this post. (Except where it is simply an accurate and
measured description of an organization that is, by all objective measures,
entirely deserving of everything I throw at it.)

Ahem.

The Flying Doctor is, at its roots, an air ambulance for a very big continent. Australia is
a massive country. Across the interior
of it, human habitation is scarce, and scattered. We have cattle stations larger in area than
many european countries, and in all of that space, there might be no more than
a couple of dozen working jackaroos (cowboys) and a family or two in a
homestead somewhere along a creek. For
most of Australia's settled history (and for all of the history before that)
when you were sick, you were sick where you were, and you lived or died on your
own out in the loneliness. All the medicine you had was the knowledge of
hygiene or basic nursing in your own head.

In the
nineteen-teens and twenties, a Reverend John Flynn (Flynn of the Inland, he is
better known today - the label taken from a famous 1932 hagiography by writer Ion Idriess ) worked the
territories as a superintendent for the Australian Inland Mission. Out there, he found himself horrified by the things that
he saw. Women and babies died in
childbirth in remote, water-less huts. Children died of treatable
diseases. Men grew crooked when broken
limbs weren't set - or were set wrong.
He told often the story of a ten year old child, who
had pulled his sick mother - in a wooden
BOX for the god's sakes - for ten days across arid desert to get her to
somewhere that might have medical help, dragging his baby brothers and sisters
along with him.

Flynn changed all
that.

In 1928, Flynn
recognized that two hot new inventions, the radio and the airplane, had the
potential to do something entirely unprecedented in Australia. He set up a
network of radios across the bush, and brought in a fleet of spanking new
airplanes to act as an air ambulance service across the inland
territories.

It was a rough and
ready sort of set up. The radios were
primitive, pedal-powered sets and the planes were boxy little biplanes that landed on
rough airstrips hacked out of the scrub. But it made a difference.

How it made a
difference.

The airplanes got
people to doctors and the radios opened up the world to the people who lived
out there all alone with the great big horizon. Particularly for the women,
who spent much of their lives alone in the bush with a pack of kids while their
husbands were out for weeks at a time with the cattle, the radio was a world-opener. The radio gave them companionship, and in time, it led to the School of the Air, a radio-correspondence school (still going
strong, although making more use of the internet today than the radio) for
children on remote stations, who up till then, hadn't had much in the way of
education except irregularly delivered correspondence courses, or what
education their entirely-too-busy mother could provide when not providing
everything else.

The Reverend Flynn
wasn't particularly keen on a genuinely inclusive mandate for the Flying Doctor
- in its early days he circulated opinions about Australia's aboriginal
population that shocked even the other leaders of the Inland Mission (which is
not particularly remembered today for its history of Christian attitudes toward the
non-white Australians under its dominion.
So that's saying something.)

However, the Flying
Doctor grew past its founders and and throve. Today, doctors fly out of 22 bases across Australia, flying circuits
through the stations and townships of the outback, running regular clinics and
inoculations, and getting people to hospitals when they need it. Their airplanes land in paddocks, on country
roads, and on dry riverbeds. Their right of passage is absolute.

Flying Doctor
airplanes have set the standard for rural carriers all over the world - they are equipped with specially sprung undercarriages for landing
on every sort of terrain, their cabins are equipped with advanced
pressurization capacity (they can limit the pressurization to 2000 feet to
protect patients with heart and brain injuries) and their engines have extended
air range for long-haul outback flights. The Royal Flying
Doctor Service is one of Australia's greatest civil and logistical
achievements, and I will take on anyone who chooses to argue otherwise. With water-pistols at ten paces, if you
please. When Australians see the RFDS, we see a net of lifelines - strings of compassion
and communication stretching out over our continent. It symbolizes the
best of what we aspire to - an absolute, unselfish cooperation and
an appreciation for our fellow men and women. I ran into a flying
doctor airplane at an airshow a couple of years back. We were permitted to look through the plane,
and when we'd prodded and gawked our fill, the pilots closed the airshow with a
fly-past over the airstrip.

Here's a flying doctor plane, on its way out to the airstrip.

And the interior of the same plane - as good a set-up as in any ER, but with seat-belts and altitude controls!

It was a
good way to end a show, with a look at the best human face of aviation, something
way beyond acrobatics and big engines and formation flying. When you look at the
RFDS, you think - we do all right. And when you see one of their planes
throttling low, fifty feet above the airstrip, you get lumps in your throat and
just about stand up and salute.

Wednesday, September 19, 2012

My sister, the
estimable Dr Tabubil, is spending ten weeks on a rural clinical rotation in
Cloncurry, a small pastoral town in the Queensland Outback. It's a fantastic place, and together we have
collaborated on a series of guest posts all about living and working in the Red Centre. Enjoy!

Small towns have large shares of characters. Driving to the
hospital one morning I drove past what is probably the oddest thing I have
every seen. There was an old man in an Akubra walking a
bull on a leash. A pet bull. The bull’s name is Toolabuc… and he’s
registered as a dog in the shire of Cloncurry. He’s well trained. Every day he
goes for walkies down the whole length of the town. He was rescued from a future of hamburgers as
a newborn calf. He was hand-reared, and
now weighs 770 kilograms. And walks on a
leash. He knows the way to the Post Office Hotel, where his owner will have a
glass of rum (or five) before it’s time to turn around and go home. His owner's watering hole is next door to
the home of one of the GPs. It’s not a
happy relationship.

There’s a man in
town that everyone knows quite well. Apparently, he is filled with ideas on how
to improve the town. His plan, they say,
is to turn Cloncurry into the Las Vegas of North West Queensland (imagine that!) He wants to start by turning the local
motel/caravan park into a legalized brothel.
Not that rooms 10 and 11 don’t make up the unofficial town brothel
anyway. He is so dedicated to his cause
that he ran for shire council to get his ideas approved. He couldn’t understand why he only got two
votes (one was his own). “Everyone in
town promised they’d vote for me!” I
think his dreams of legal prostitution in this tiny country town will have a
wait a while he comforts himself with the key to Room 11…

Speaking of the
caravan park, on one of my strolls down the town’s one main road (which is also
the main road across the continent. Yes,
the town evolved around a little country road, and when the little country road
got upgraded to a highway, the planners didn’t run a diversion, just plowed
right on through) on a Sunday afternoon (and I can walk it in less than an
hour, notwithstanding the windburn from passing road trains), I overheard the
afternoon’s entertainment entertaining the Gray Nomads in the caravan
park. There was a rather insipid but
enthusiastic man-and-woman duo singing popular American country songs
interspersed with jokes a la Australiana:

“I always like to
ask travelers if they have nicknames for their wives. I asked this one bloke from Alice.

'Yeaaaah, he
said. "I call my missus Harvey
Norman.'

'Harvey Norman!' I
says. 'What for?'

'What for?' He
says. '12 months innerest free!'

(Note: Harvey Norman
is the name of a large national chain that sells furniture and electrical
appliances. We enjoy a very high level
of humor out here. I’d rather go and
watch the under-twenties slow dancing in the pub.)

I walked past the
Oasis again yesterday night at Happy Hour. There was a wizened old man
playing mournful songs on his accordion while caravaners drank wine coolers and
made small talk. It was not inspiring.

(editor's note: This sounds lovely! A convivial evening in the country in the
caravan park? Can I come along too?
What’s not inspiring about that?

Reply from Dr
Tabubil: There is absolutely no way this
is inspiring. It was one of the LEAST
inspiring things I have ever heard. He
was a sad old man, so tired out that the accordion almost hid him from
view. It was like he didn’t even have
the energy to play a faster song. It was like the
moment in the war movie - the night
before the big battle where everyone is sitting around a campfire looking
depressed and a wounded solider plays on a mouth organ and the orchestra leaves
him alone because you know everyone is going to die tomorrow and silence and a
bad mouth-organ is sadder than music. So
please don’t try to make it inspiring, okay?

Monday, September 17, 2012

My sister, the
estimable Dr Tabubil, is spending ten weeks on a rural clinical rotation in
Cloncurry, a small pastoral town in the Queensland Outback. It's a fantastic place, and together we have
collaborated on a series of guest posts all about living and working in the Red Centre. Enjoy!

After three weeks in
Cloncurry, I hit a wall. It’s lonely out
here. It's a tiny town, with very few
social opportunities besides the pub, and there's nothing much around but scrub
- for hundreds of miles in every direction. I was given a shire council car
when I arrived, but it's a compact European make and totally unsuitable for
driving outside city limits. Ten months
ago, the doctor in my position drove up to Isa and back. She came home late at night, which for city
folk is a huge danger: there are cows
out here in cattle country - black cows that wander onto the roads at night,
where the bitumen is warm through retaining the heat of the day. All that you can see of them are their eyes,
usually at the moment that they fly through your windscreen.

This doctor missed
the cows, but she hit a large kangaroo. Kangaroos cause a
significant number of accidents on Australian roads - in fact, they're probably
the one thing that actually scares country people. They can bash up your car pretty good -
particularly if you're in a small-ish sedan, but the real danger is if they go
through the windscreen: they come through and they keep kicking. In this particular case, the doctor was
uninjured, but the car was in the shop for 10 weeks.

As a consequence of
the accident, I have the car, but I'm not allowed to drive out of town in it -
just in case. You can imagine how
frustrating this can be. So when I hit
this wall, I begged and I pleaded (I might even have groveled a little) to be
allowed to drive to Mt Isa - 120
kilometers to the east, for a few hours change of place. I had a real reason to go - a friend was flying in to visit her sister, who lives
there, and we really wanted to catch up.

My begging and pleading paid off, with
restrictions: I could go, but I could do no driving between 5pm and 9am to
avoid the ‘roos and the cows. I was more
than happy to comply, especially when the Powers That Be suggested that I stay
in Isa overnight and drive back the next day, even offering to re-schedule my
patients for the morning so that I could drive back in daylight and in
safety!

The drive was
beautiful. The road is well travelled,
and has recently undergone some major improvements, most notably the addition
of real overtaking lanes every 20 to 30 kilometers. This has been a major useful change to the
road - particularly in the places where caravans (carrying hordes of Australian
Grey Nomads) and road-trains with two or three trailers behind them, slow down to struggle
up the shallow hills.

The Road to Isa

The
road meanders through low red hills,
covered with bush grass and spinefex, and scattered gum and bloodwood
trees. It is pure desert out here.
Straight out of the movies. The
only things missing are the saguaro cactuses - you know, the ones that look
like fingers - tall and skinny and cinema-shorthand for Hot and Dry and
Empty.

On the way up to Isa
I stopped at every single stopping bay, often just a fifty meter stretch of
dirt along the side of the road, to look out at the bush. Occasionally, there are stretches of
sidewalk, that start randomly, run for five meters, or fifty meters, and stop
again, just as randomly. I’m not sure
who uses them. Nobody seems to know why
they were built.

It’s a pity none of
these stopping areas touched on a creek – I would have loved to photograph the
creeks here, but the traffic runs so fast and fierce that it’s far too
dangerous to stop on the roads. They
have quintessential bush names like Dingo Creek and Gum Creek, but there are a
few wilder names - such as Salmon Gorge Creek.
It’s probably the most unassuming creek around. Flay and dry and lots
and lots of nothing. No gorge anywhere.
All the creeks out here are all bone dry.
They range from 3 to 20 meters across, flat beds of red sand and not a
spec of water. There are empty creek
beds everywhere across this country. The
country does flood in the wet season (in fact, one of the nurses at the
hospital hitches a ride to work on the family’s helicopter when the roads are
flooded) but right now it’s simply impossible to imagine what they would look
like full. Although it's the
dry season right now, there is still a little water in the Chinaman Creek
Dam. One day last week I drove up to the
dam and stomped about (dodging black flies, rural Australian style, all the way) taking photographs, to show you what this country looks like in
the wet. They say that there are snakes
out here. I haven't seen any - it's winter and it's too cold. But I saw a snake's slither track once. Does that count?

The
biggest culture shock I've experienced out here in the Red Center isn't the
desert stretching out all around us, with its hundreds of miles of nothing
there but kangaroos, ta ta lizards, and cows, but the lifestyle of the country folk. There’s a little bit of everything out
here. The ones I love the most are the young men and women who work out the stations. I get a secret little thrill and tingle down
my spine when they say, “I’m a Jillaroo at Devoncourt" or “I’m the
Jackaroo at Fort Constantine Station”.
Maybe it’s because I didn’t grow up here in Australia - where our
cowboys are known for fair dinkum drovers, where the jackaroos and jillaroos
muster cattle by the hundreds of thousands, and horses by the hundreds (as
working horses for the mustering of the cattle) across thousands of square
kilometers of Australia, and drive them across the country to cattle-yards for
transport on road trains to the slaughter house in the city, over a thousand
kilometers away. It's something that
I’ve never been exposed to before, nor ever understood – until now, out here!

And then we’ve got
the truckies - the modern-day drovers, whose sole purpose of occupation is
transporting goods back and forth across the millions of miles of road in this
country. Out here, road trains go from
the East Coast (Brisbane or Townsville), through Emerald or Charters Towers,
then they roar down the main road of Cloncurry and pause for a rest at the Road
Runner Road House or the Coyote Inn and plow on through to
Isa, where they stop for the night before
dropping down onto the endless plains across to Alice and even further
beyond that, Perth. The Road Runner Roadhouse in Cloncurry.

There are a lot of drugs
out here among the truckies, and there are regular drug screens by trucking
companies and rail companies. At a
barbeque I overheard one manager of a train company- who is an ex-truckie
himself -say, “I bring my guys in for drug screens all the time. It’s the speed. I know the signs. I’ve been on it so many times myself.” He used to do a round trip from Toowoomba to
Perth in 8 days. That’s over 6000
kilometers of straight road where there’s nothing to break the monotony of
empty horizon except kangaroos waiting to be hit. Truckies swallow amphetamines like
candy. It keeps them awake and gets them
home faster for an extra day with their children before they are on the road
again. And the road goes on - all the way to Perth.

The distances that
my patients travel as matter of course - without even thinking about it - are
huge. People from the further stations
can travel almost two hundred kilometers of dirt roads before they even meet bitumen.

One jackaroo I saw –
he had been rolled on by a cow during a muster, and wounded, and had come in to
town so that I could change the dressing on the wound for him.

“Right. I said.
I’ll need to see you again the day after tomorrow."

He blinked twice,
but said nothing. Just nodded stoically.

“Erm.” I said. “How
far away are you again?”

“Four hours, each
way.” He said. He had come 150 km, on an
ungraded dirt road that most of the time was a cattle track, just to see the
doctor. And didn’t think that it was anything
special.

Right. So the nurses taught him to clean his leg and
change his own dressing. I saw him two
weeks later – which is still really soon for a trip like that.

Friday, September 14, 2012

My sister, the
estimable Dr Tabubil, is spending ten weeks on a rural clinical rotation in
Cloncurry, a small pastoral town in the Queensland Outback. It's a fantastic place, and together we have
collaborated on a series of guest posts all about living and working in the Red Centre. Enjoy!

Driving
into town from Mount Isa, Cloncurry begins when you pass the first pub and the
lawn bowls club.

The Cloncurry Lawn Bowls Club

Cloncurry's
pubs are very important to the social (and cultural even!) life out here.There are 4 main drinking holes in town.The most popular is the Leichardt (Named for
the 19th Century explorer Ludwig Leichardt). One of the
big draws of the Liechardt is it’s restaurant – they serve quite an adequate
steak (we’re in steak country after all, although the Wagon Wheel has the BEST steak in town).But the pubs aren't really about the
food.Next door to the restaurant, the
Leichhardt has a pub, that turns into at disco after 10 pm. The place really
fills up after midnight with a hundred sexually active young men and
women.The dance floor is packed and the
crush at the bar is three people deep. (Which is very deep for a little town!)

The Leichardt Hotel

Alcohol isn’t cheap
out here – it costs to have it shipped in - but the booze flows all night long. What else is there to do for sexed-up young
people in a little town in the middle of the bush one hundred and thirty kilometers
from Isa and a thousand kilometers from the coast?There’s a lawn-bowls club, but that is for
the over-60 crowd. There is a cinema.It’s open-air, where you bring your own chairs, but it’s been closed for
a few years now.

The Cloncurry Cinema

And the young people
have money to burn.So they drink. And
they shag. And they come to see me the morning after. The ladies dress up in
their smallest, slinkiest dresses (not high heels though – this is the Australia's
Red Center!High heels'd get too darned
dusty.) and the gents refuse to put in any effort: they wander into the pub
wearing shorts and thongs (note to North American readers - thongs are what you
would call flip-flops.You wear 'em on
your feet) - a costume that's the perfect recipe for being denied admission to
any pub in Brisbane.

One night I was
sitting at a bar, nursing a drink and chatting with work colleagues, when a
rather unsteady gentleman moseyed up next to me to order a Bundy and Coke
(that’s Bundaberg Rum and coca cola for the uninitiated).He seemed inordinately pleased with his
wallet, holding it out and catching my eye like he was begging me to comment.

“Nice wallet,” I
obliged.

“Yeah,” he
slurred.“It’s like green and sh**t.”

And there ended his
chances for further conversation.

The incidence of
sexually transmitted infections out here really is spectacular.Currently, the Mt Isa medical is fielding a
Syphilis epidemic. In Australia -in
2012!At our clinic it is standard
practice to offer an STI screen along with every Pap smear (regardless of the
age of the woman).And we offer a full
STI screen at every doctors visit for every patient – of any age and
gender.Our standard tests are Chlamydia
and Gonorrhea swabs, and we always encourage HIV, Hepatitis C and a Syphilis
serology along with them.This we do
even for backpackers from overseas, who are passing through and who don’t have
medicare (editor's Note: Medicare is Australia's national health care system.) and
have to pay the full costs of the tests.If you’re interested, it costs $488 dollars to be screened for those
five infections.Only three of them are
easily treated.So play sensible, okay?

And then there are
the backpackers.Cloncurry is a major
destination on the working-holiday track.Kids come through all the time, and most of them pick up work in the
pubs, where the fun is.

And this is my
medical conversation, about a week after every single one of them arrives:

"Hi Doctor. I've come to
inquire about what sort of birth control you offer here in Cloncurry."

"Well, we've
got condoms.And the pill.And the IUD.Condoms are good."

"Ah - I think
that the pill sounds exactly like the sort of thing I'm wanting."

Wednesday, September 12, 2012

My sister, the
estimable Dr Tabubil, is spending ten weeks on a rural clinical rotation in
Cloncurry, a small pastoral town in the Queensland Outback. It's a fantastic place, and together we have
collaborated on a series of guest posts all about living and working in the Red Centre. Enjoy!

Hey Tabubilgirl -

So i had some
patients in with me (gray nomads) that i needed by boss to review for me.
As they left they made some comment that i didn't catch.

Anyway, later on i
called my boss about another patient, and he goes, "you've got fans in
Port Maquarie. They think you're sh**t hot!"

Heh.

I have fans in port
Macquarie.

The Gray Nomads are
the retired men and women who close up their houses and spend months out of
every year on the road in caravans and camper-vans, exploring Australia. As the baby boomers age, the pastime is
becoming increasingly popular, and brings with it into the outback the ailments
and illnesses of the elderly, at a scale that really hasn’t been appreciated
out here before. Most grey nomads
usually present with the influenza and want some antibiotics, but occasionally
we do get one with cardiac failure - such as the dear old soul who, when she
thought about it, “was supposed to get
that echocardiogram before setting off on this 4 month journey across the
outback.”

Oh dear.

There was also the
elderly gentleman who arrived at the clinic delirious with the flu: so
incoherent and muzzy that he managed to drive his car and caravan right into
the back parking lot (reserved for the clinic staff), ignoring the multiple signs marked “Do
Not Enter.” Our car park has a long,
narrow entrance, leading to a very small lot at the back. It's big enough for about seven cars,
if they’re very friendly with each other, but it is definitely not large enough
for a trailer. We noticed his arrival
when we heard a loud bang. The building
shook. I, of course, thought that the
nearest mine was blasting that day, but they don't blast that close, do they?! Turns
out not - the gentleman had backed into
a supporting post for the building.

It was a close call,
and once everyone had panicked and moved their cars out of his way in a real
big hurry, he managed to find his way out.
I thought that I had done a few10-point turns in my day! He topped my
record by far.

Monday, September 10, 2012

My sister, the estimable Dr Tabubil, is spending ten weeks on a rural clinical rotation in Cloncurry, a small pastoral town in the Queensland Outback. It's a fantastic place, and together we have collaborated on a series of guest posts all about living and working in the Red Centre. Enjoy!

The patients here in Cloncurry are typical for a small town in cattle grazing country, with a high and regular flow of tourists (Grey Nomads and Backpackers) coming through. I have my regulars, who are already disappointed I’m only there for 10 weeks (yay!) and I see a fair amount of the transient population - the workers from the more remote stations, and the men and women who work in the mines nearby.

The countryside around Cloncurry seems to be littered with mines. The mother load around Cloncurry is copper. Just recently, though the Great Australian Mine has just found a rich body of Gold that will yield some spectacular kilo loads per tonne and keep the mines in cash for a long time - even if (or when) the copper runs out. These miners are young men and a few women who, once finished with school ( at 16 if they drop out, 17 or 18 if they graduate) sign a contract with the mines for a very large starting salary - AUD $80 000 a year.

Occasionally it can be frustrating when these young miners ask for a little too much. Occasionally they'll present to the clinic with a medical complaint, and expect to be bulk billed (Bulk billing is what happens when you are on medicare, our national health-care scheme, and the whole bill is taken care of by the medicare plan.)

Apart from that, I LOVE bulk billing. This generally applies to people on a pension, or under the age of 16, or people who have a DVA Veterans card or some other sort of concession, but up here we have some reasonable discretion about when and how to use it – like if they have come in on a recall for results, or it was a hellish day and the patient waited for 2 hours for us to be free. Or, in my case, when I stumbled upon a patient’s recent personal tragedy, and made her cry, by saying, in a really bright voice - “Are there any preexisting conditions in your family?”

And she burst into tears and said “My brother is in a full body traction cast! He fell off of a quad-bike last week!!” and cried and cried and cried.

I felt so awful. I spent 15 minutes just sitting there and holding her hand and listening while she told me all about it. It was so sad. I definitely bulk billed that one.

People come from all over to work in the mines - from all over Australia, from all over the world. I love my job – I meet so many people. My favorite part of a consult is the moment when I say:

"Hello – who are you? And where are you from?"

Because I get a story. People will come up to the mines for six months, or for a year, for two years, on a sabbatical from an academic job, because they're on the run from a spouse or some other family situation, and they'll make enough money to go home for a while, and then they'll come back again. Again and again and again. The outback seems to get into your blood.

And then there are patients from the really wealthy cattle families. One family in particular is the tenth richest family in Queensland. Based out of Cloncurry, they own a full third of Queensland's grazing country. Their trip in for a checkup is racked with hardship – do they fly their private plane to town, or drive up in their Bentley?

Bulk billing is fantastic – I really got into the swing of it, until the boss had to come and tell that I needed to ease back a little.

"Dr Tabubil - we appreciate that you're being a compassionate doctor, but – this is Cloncurry. Not Brisbane. If they look like they can afford it – charge them. If they look like they can’t afford it – charge them anyway. Chances are their private jet is waiting for them at the airport to take them back to the muster, which is why they look like they've been rolled on by a horse and they smell like the back end of a stable. They are working millionaires."

Of course, there are people here in town who really can’t afford it. But the reception staff knows who they are and they probably have a concession card anyway.

Even so, when some eighteen year old kid comes in after I’ve seen him throwing bills on the bar the previous night in the pub and looks at me and says -

"SO, can ya, like, bulk bill?"

Well, when that eighteen year old is making 80 000 dollars a year, I generally sigh, and smile sweetly, and say “Oh, NO, I’m sooo sorry. It’s just not applicable.”

About Me

I am an Australian architect, married to a Canadian who followed me home.
In September 2011 we relocated from rural South Australia to the bustling metropolis of Santiago, Chile, where it's warmer than Canada, but less insect-y than Australia.
How's that for a compromise?